Your thoughts and advice please

[Volley]

Dorsey is a 13 yo neutered Scottish terrier diagnosed with diabetes in March after few weeks of symptoms. He weighs 24 pounds. Initial BG readings were in the mid to high 500 range. My vet is excellent - suggested I buy the same alpahtrak2 meter they use, had me verify readings against their meter and showed me how to administer the Novolin N she prescribed. Dorsey would not eat the Hills prescription wet or dry together but would eat the dry food if he still got his normal packet of Little Caesars at each feeding. We started at 3 units 2x a day at meal times, progressed to 5 units and then 7 units, all without getting good control. Things got much better at 9 units and here are the curve values after moving the evening dose to 1 hour after meal. We moved the evening dose in an attempt to lower early morning BG readings over 400 and it worked. Mid morning and evening readings were otherwise quite similar between the 9 unit curves.

TIME READING REMARKS
7:00 AM 276
8:00 AM NONE Fed 3.5 oz packet Caesar wet and ¾ cup Hills w/d dry, followed by 9 units insulin
9:00 AM 280
11:00 AM 186
1:00 PM 264
3:00 PM 238
5:00 PM 204
6:00 PM NONE Fed 3.5 oz packet Caesar wet and ¾ cup Hills w/d dry,
7:00 PM 239 Gave 9 units insulin after BG test
9::00 PM 164
10:00 PM NONE Exercise by walking ~ 4 blocks
11:00 PM 83 Ate a treat after BG reading.

Sorry but I am too new to the forum to post an image of the curve so can only provide readings.

Here are my questions:
1) Do you think these values demonstrate adequate control.
2) Should I be concerned about the 11 pm reading being too low.

My vet is happy where we are and I tend to agree but would like other's thoughts to discuss with her if needed. Thanks in advance.

[Lolo]

Re: Your thoughts and advice please

Do you know if exercise typically lowers your dog’s BG? That could be the reason for the 83. A 10-15 minute walk can drop mine drastically (100+ pts) but I know it can raise other dog’s. If exercise does lower your dog’s numbers I wouldn’t change a thing except maybe when you walk him. Since Dorsey’s nadir seems to be 2-3 hrs after eating you may want to avoid exercise during that time so he doesn’t drop too low. It looks really good otherwise!
Also some dogs need a different dose AM vs PM. Mine runs higher at night so I actually give her a more generous dose PM.

[jesse girl]

Re: Your thoughts and advice please

I agree with lolo and the 83 you saw could have been caused by the walk

Its possible you may have to find a better time when insulin is not as active , I walk jesse right before her insulin shot

Jesses NPH insulin's onset is 1.5 hours after her shot

Now My jesse dropped quite a bit during her walk and i had to give her a lick of honey off a spoon before she went but over time her body adapted and did not substantially drop anymore so we stopped doing the honey lick

depending on what number you normally see before the walk you can determine how much your dog can drop during . I try with jesse to be less than 50 points

Always carry liquid sugar and a carby treat like a milk bone when going on walks if sugar does go a bit low and some symptoms show up

Now walks are important for a dog and diabetics should go and enjoy . You just want to remember there can be some limitations to what we do with our dogs . You can test blood sugar before and after a walk and see what blood sugar is actually doing

Numbers do look good

[Scooterspal]

Re: Your thoughts and advice please

Allowing those BG levels to remain above 250 can lead to blindness from developing cataracts. If you're using the Novolin N now, the intermediate version, I'd ask the vet about adding Novolin R, the fast acting version, to get the levels to drop quicker.

You would probably be able to lower the dosage on the Novolin N by doing so.

Midday levels in the mid 100's are where I like to see Scooter.

[MikeMurphy]

Re: Your thoughts and advice please

Those are great numbers. The ideal BG range for a diabetic dog is 150 - 250.

As Lolo and jesse girl said, the 83 is a concern. Testing before and after his walk will help determine the best time for a walk.

My Lily’s BG can drop significantly after a walk, so to prevent her from dropping too low, I give her a few mini milk bones along the way.

Nice work

[Volley]

Re: Your thoughts and advice please

Thank you all for these excellent comments. Cataracts is the underlying reason for my first question but I was unsure if anything could be done to further lower the morning readings based on the 83 value at night. I had not even considered the effect of exercise on the evening BG readings so kudos to the posters. I will take some before and after nighttime walk readings but I am certain Dorsey's BG levels are being lowered by his walk. If confirmed I will change his walk time and see what his curves reveal. Then will discuss the use of Novolin R with the vet. Thank you all again for your comments.

[Lolo]

Re: Your thoughts and advice please

Honestly I don’t think you need R at all. Your dog stays pretty steady, he even dropped a bit PM, after eating. Mine on the other hand spikes significantly after a meal so R would be appropriate. I wouldn’t give R to a dog that has fasting BG in the range yours is AND that doesn’t get a food spike.
Your numbers look awesome (I’m envious!) and any minor highs/lows could be fixed by changing walk times.

[MikeMurphy]

Re: Your thoughts and advice please

Honestly I don’t think you need R at all. Your dog stays pretty steady, he even dropped a bit PM, after eating. Mine on the other hand spikes significantly after a meal so R would be appropriate. I wouldn’t give R to a dog that has fasting BG in the range yours is AND that doesn’t get a food spike.
Your numbers look awesome (I’m envious!) and any minor highs/lows could be fixed by changing walk times.

I totally agree. I use R to correct high BG after eating. With your excellent numbers, it’s not needed.

[Volley]

Re: Your thoughts and advice please

Wonderful. This further eases my mind and I will concentrate on any change in BG from exercise and modifying time of exercise if needed. I have one additional concern regarding Dorsey's wet dog food. I have fed him Cesar packets (plus dry food) all his life and am now concerned I may be introducing a variable into his daily BG and curves. Cesar makes a number of flavors (beef, turkey, lamb, etc) and styles (classic, fillets, savory, home, etc). It has been my practice to buy a variety of these flavors and styles and feed a different one at each meal. I know consistency of food is important for stable BG patterns. Any advice on whether there is nutritional standardization across such products and if I should be limiting Dorsey's food to a single style or even a single flavor?

[jesse girl]

Re: Your thoughts and advice please

If the different types compare as far as calories and ratios of things like proteins and other types of food your probably ok . Your basically using it as a topper . The key for diabetics you want them to eat consistently day in day out

Your testing blood sugar at home so you will be able to tell if there is a change . I am not real rigid with jesses routine because when i was it did not make much difference either way

I am happy with jesses sugar between a 100 and 250 and she has been like that for over 8 years and has kept her site ( knock on wood ) sometimes she can be lower sometimes higher .She can have periods of really good sugar and then periods of not so good . Blood sugar and the body is never static . Changes happen all the time and then change back . Sometimes it gets me dizzy but jesse and me role with it

Now some are very rigid with there routine and have very tight control of blood sugar and thats good for them . Everybody has their own individual idea for their dogs regulation depending on their own circumstances

[Lolo]

Re: Your thoughts and advice please

I would just look for a style that has the lowest fat and maybe stick to lower fat flavors too. Diabetic dogs can have a higher risk for pancreatitis which can be triggered by fat. It’s just something to be aware of. And like Jesse said, you test at home so you will be able to see if diff flavors have any impact on his numbers.

[amydunn19]

Re: Your thoughts and advice please

You can look at the labels and compare the protein, fat, and fiber percentages and the ingredients and stay with things that have similar amounts of each. I did rotate proteins with Maggie - chicken, turkey, lamb and duck. She was very picky and wouldn’t eat potatoes or rice, so I stuck with legumes as carb sources. Her numbers didn’t fluctuate when I changed from one protein to another.